Beyond vertigo: vestibular, aural, and perceptual symptoms in vestibular migraine

Abstract

Purpose: To review the vestibular, aural, and perceptual symptoms of vestibular migraine (VM) that may present alongside vertigo.

Recent findings: Increased research attention to the wide spectrum of symptoms presenting in VM patients has improved understanding of this disorder, with recent identification of five different VM phenotypes. Research into the clinical overlap between VM and other chronic vestibular syndromes such as persistent postural-perceptual dizziness and mal-de-debarquement syndrome reveals a range of vestibular symptoms and hints at pathophysiological connections between migraine and vestibular dysfunction. Studies of migraine treatment for hearing loss suggest patients presenting with aural symptoms may have an underlying diagnosis of migraine and deserve a trial of migraine preventives. Research into the neurologic basis of the perceptual disorder Alice in Wonderland syndrome has revealed brain areas that are likely involved and may help explain its prevalence in VM patients. VM is a sensory processing disorder that presents with more than just vertigo. Understanding the range of potential symptoms improves diagnosis and treatment for migraine patients whose diagnosis may be missed when only the symptoms identified in the diagnostic criteria are considered.

Keywords: Alice in Wonderland syndrome (AIWS), Hearing loss, Mal-de-debarquement syndrome (MDDS), Otalgia; Persistent postural-perceptual dizziness (PPPD), Tinnitus, Vertigo, Vestibular migraine

Ceriani CEJ. Beyond vertigo: vestibular, aural, and perceptual symptoms in vestibular migraine. Curr Pain Headache Rep. 2024 May 23. 2024. Review.